Objective To investigate the influence of dexmedetomidine by continuous intravenous infu-sion on the recovery process of patients undergoing laparoscopic radical hysterectomy surgery under general anes-thesia.Methods Eighty patients,ASAⅠ~Ⅱ,scheduled for laparoscopic radical hysterectomy surgery under general anesthesia,were randomized into group C and group D.Normal saline and dexmedetomidine at the dose of 0.6μg.kg-1 .h-1 were injected into different groups from 10 mins before the operation to 20 mins before the end of operation respectively.Heart rate(HR),mean arterial pressure(MAP) were recorded at following five time points:before anesthesia(T1),10 mins before extubation(T2),extubation(T3),5 mins after extubation(T4), 10 mins after exbubation(T5).The recovery time,cough reflex score,sedation-agitation scale(SAS),Ramsay score,the occurrence rate of untoward effect and the dosage of medication were observed.The observational indi-ces were analyzed by using t-test,chi-square test,repeated measures data of ANOVA or the Mann-Whitney u test method.Results Compared with group C,during the recovery process,MAP and HR in group D was more stable.Ramsay score in group D was higher(P<0.05).The SAS in group D was lower(P<0.05).The sedation-agitation scale in group D was lower(P<0.05).The occurrence rate of agitation and tachycardia was lower in group D(P<0.05).But the occurrence rate of bradycardia was higher(P<0.05).Meanwhile,usage amount of sevoflurane was lower in group D(P<0.05).Conclusion Dexmedetomidine continuous intravenous infusion re-duced the untoward effect of extubation,did not extend extubation time,and kept more stable haemodynamics.

MicroRNAs(miRNA)are a kind of small non -conding RNA,which negative regulate target genes expression at post -transcription level by binding 3'-untraslation region(3'UTR).Dysregulation of miRNA pro-files relate to cancer,immune disorders,cardiovascular disease,neurodegenerative diseases and metabolic diseases. miR -221 /222 are two similary miRNAs,which share the same promoter and have the same seed sequence.miR -221 /222 usually target to same target genes and co -regulate same processes and act as onco -miRNA roles.Howev-er,miR -221 /222 maybe act as suppressor in cancer which maybe dependent particular context.The roles of miR -221 /222 are reviewed in this article,will provide a comprehensive vision for comprehending the biological process of miR -221 /222 in carcinoma.

This article described systematically the design basis,passing standard and influential factor of test score of the assessment scale of simulated clinical skills examination.Through developing and modifying OSCE examination scale design for many years,we have found that the use of 360-degree assessment for designing OSCE assessment rating scale can effectively reduce the impact on the score of examinee owing to the environment,the candidates,raters and question design,which has an important role for scientific development of OSCE assessment scales,as well as improving the reliability and validity for development of a scientific OSCE assessment.

Objective To evaluate the feasibility of renal artery angiography with interpolated finite impulse response (IRFR) sequence on 1.5T MR. Methods A total of 122 subjects underwent MR scan with IFIR sequence. On axial image of IFIR, bilateral signal-to-noise ratio (SNR) and breath artifact of renal artery were measured and 3D maximum intensity projection (MIP) images were reconstructed on workstation ADW 4.3, and each branch was scored according to its displaying quality. Influence of SNR, age and breath artifact on the displaying of renal artery were compared and analyzed. Results Renal segmental artery could be seen in 112 subjects (91.80%). Among them, segmental artery was showed clearly in 78 subjects (63.93%), post-segmental artery was showed in 54 subjects (44.26%) and branches of post-segmental artery was showed in 22 subjects (18.03%). There was statistical difference of renal artery scores mean rank between ≥60 years group and ＜60 years group (49.25 vs 67.48, P=0.006), as well as between the group without and with breath artifact (66.66 vs 43.35, P=0.002). No statistical difference of SNR was found among renal artery scores from 1-5 (P=0.177). Conclusion IFIR sequence is simple and safe for renal artery angiography on 1.5T MR, and different grades of renal artery branch can be showed clearly.

Objective To explore the roles of p53 in ionizing radiation induced MCF-7 cell cycle uncoupling. Methods The p53 knock-down models was established in MCF-7 with retrovirus packaged particles from 293T cells through calcium acid phosphate co-precipitation, then Western blot was used to detect the protein expression. Flow cytometry(FCM) was used to analyze the cell cycle uncoupling and polyploid after irradiation. Results Compared with p53+/+ group, the percentages of G0/G1 cells in p53 -/- group decreased, while those of S and G2+M increased (P < 0.01). In polyploidy analysis 2N cells decreased, whereas both 4N and 8N cells =increased (P<0.01). Compared with sham-irradiation, 4 Gy X-ray led to the decrease of G0/G1, S cells, and the increase of G2+M cells. The increase of 2N cells and decrease of 4N and 8N cells were observed in both p53+/+ and p53-/- cells. Compared with p53+/+ +IR group, the decrease of G0/G1 and S cells and the increase of C2 + M cells were significant (P < 0.01) in p53-/-+ IR groups. 2N cells decreased, 4N cells increased, but no changes in 8 N cells occurred. Conclusion Radiation might induce G2 arrest and cycle uncoupling, p53 plays a role in the regulation of G2 arrest, but no role in cycle uncoupling.

Objective To evaluate the roles of multi-voxel proton magnetic resonance spectroscopy (1H-MRS) in the early diagnosis of vascular cognitive impairment no dementia (VCIND).Methods Seventy-eight out-patients and inpatients in Department of Neurology, the second Affiliated Hospital of Soochow University from December 2008 to September 2009 were recruited in this case-control study.Their cognitive functions were assessed with a wide range of neuropsychological battery of tests including Montreal cognitive assessment ( MoCA Beijing Version ), auditory verbal learning test ( AVLT), digital span test (DST), Rey-Osterrieth complex figure test (CFT) ,semantic and phonetic fluency tests, digit symbol coding subtest (DSCT), trail making test (TMT), clock drawing test (CDT) and the Stroop color-word test (SCWT).All patients were classified into vascular cognitive impairment no dementia (VCIND) group and cognitive normal control group based on the results of neuropsychological tests.Eighteen patients with VCIND and 18 gender-, age- and education-matched normal control were randomly selected for the following study.With multi-voxel 1H-MRS, the levels of N-acetylaspartartate (NAA), creatine (Cr) and choline (Cho) in gray matters of bilateral frontal lobe, temporal lobe, parietal lobe and thalamus were measured and the ratios of NAA/Cr, Cho/Cr were compared between the two groups.Meanwhile, the correlations between scores of MoCA and its sub-items and the ratios of NAA/Cr, Cho/Cr were analyzed in VCIND group.Informed consent was obtained from all participants and the study was approved by the Ethics Committee of the hospital.Results Compared with control group, the ratios of NAA/Cr were significantly decreased in bilateral gray matters of thalamus ( left, 1.56 ± 0.49 vs 1.89 ± 0.48, F = 11.222, P = 0.002; right,1.63± 0.45 vs 1.86 ± 0.33, F = 5.358, P = 0.027 ).No significant difference were found in NAA/Cr in gray matters of bilateral frontal lobe, temporal lobe, parietal lobe and Cho/Cr in all regions between two groups ( all P ＞ 0.05 ).In VCIND group, the decreased degree of NAA/Cr in bilateral gray matters of thalamus was significantly positively correlated with the MoCA total score ( r = 0.54, 0.44 ) as well as the sub-scores in tested items of memory ( r = 0.61, 0.49 ), attention ( r = 0.43, 0.36 ), language ( r = 0.39,0.31) and visuospatial or executive( r = 0.29 , 0.33, all P＜0.05 orP＜0.01).Conclusions Cognitive impairment in patients with VCIND maybe related to metabolic dysfunction of neurons in bilateral thalamic.Multi-voxel 1H-MRS plays an important role in early diagnosis and monitoring disease progression of VCIND.

Objective To explore an effective method for enhancing basic clinical skill of students.Methods Selective course of basic clinical skill was launched for the fourth grade clinical medicine students by using simulation-based medical education (SBME).Elective courses have 21 class hours,involving 15 items of basic clinical skills in internal medicine,surgery and nursing.Training methods include preparation,explanation,demonstration,operation,group competition,examination and questionnaire.Selective course examination includes class activation and final examination,accounting for 20％ and 80％ of the final scores,respectively.Scores were classified into A (excellent),B (good) and C (moderate) levels.Scores and questionnaire data were processed by Microsoft Office Excel 2007 software and percentages of score and questionnaire feedback were calculated.Results Results suggested that the scores of 70％ students were more than 90.Results of questionnaire indicated that the basic clinical skills of 76.6％ of the students were improved a lot.79.2％ considered that it was useful for their clinical practices.Conclusion Clinical-skill course based on SBME is conducive to enhancing basic clinical skills of students.

Objective To investigate the expression of DRAM in breast cancer cell line MCF-7 in radiation-induced autophagy. Methods GFP-LC3 transfection method was used to observe autophagy bubble.Real time-PCR was used to detect DRAM and MAPLC3 from transcriptional and translational level,respectively. The silencing vector from gene engineering was introduced by calcium phosphate transfection.Results Compared with the control group,GFP-LC3 increased significantly after 8 Gy irradiation by immunofluorescent assay,and the level of MAP-LC3 expression was higher than control group after 8 Gy irradiation by Western blot ( F =5.38,8.72,10.63,15.23,20.78 and 55.23,P ＜ 0.05 ).DRAM protein expression increased significantly at 2 h in the 8 Gy time-dose study,up to maximum at the 32 h( F =116.34,P ＜ 0.05 ).In DRAM model,the expression of LC3 and DRAM decreased significantly (F =20.36 and 40.35,P ＜ 0.05 ) and DRAM expression increased 8 Gy post-irradiation,but still lower than that in 8 Gy irradiation wild-type group.The LC3 expression also decreasaed 8 Gy post-irradiation(F =50.34,P ＜ 0.05 ).Conclusions DRAM plays an important role in irradiation-induced autophagy in breast cancer cell.DRAM might participate in the process and serve as a theoretical target for clinical treatment of breast cancer.

Objective:To summarize and compare the characteristics of oral microbiota in women during the preconception period and the third trimester.Methods:This retrospective cohort study involved 55 women who were recruited in the Preconceptional Offspring Trajectory Study (PLOTS) conducted by Fudan University and followed up to the third trimester in the Maternal and Child Health Care Hospital of Jiading District of Shanghai from September 2016 to December 2019. A total of 110 unstimulated saliva samples were collected in the preconception period ( n=55) and the third trimester ( n=55). Features of oral microbiota in the samples were analyzed by 16S rRNA gene-based sequencing. Moreover, the related factors were also analyzed. Paired t test or Wilcoxon matched-pairs signed-ranks test were used to analyze the differences in α-diversity during preconception and the third trimester; t test, analysis of variance (ANOVA), Kruskal-Wallis test and Mann-Whitney U test for comparison between groups with different characteristics and permutational multivariate analysis of variance (PerMANOVA) for β-diversity were used; Linear discriminant analysis (LDA) effect size (LEfSe 1.0) was used to identify the iconic oral flora. Results:(1) The Ace index of oral microbiota was significantly lower in the third trimester than that in the preconception period [661.14(578.15-752.85) vs 730.64 (632.40-911.00), T=1 077.00, P=0.010]. There was also a significance difference in β-diversity ( F=12.539, R2=0.104, P=0.001). Some species such as Saccharibacteria_TM7_G3, Prevotella_7, Absconditabacteria_SR1_G1, Porphyromonas, Ruminococcaceae_UCG_014, Prevotella, Peptostreptococcus, Prevotella_2, Alloprevotella, Parvimonas, Solobacterium and Eubacterium_nodatum_group in saliva were statistically more abundant in the third trimester than those in the preconception period (all P<0.05). (2) The third-trimester Shannon index was lower among those with lower income [5.44 (5.08-5.77) vs 5.75 (5.44-6.12), U=219.00, P=0.029] and those with gargle habit after meal or dessert [5.36 (4.91-5.48) vs 5.72 (5.44-6.05), U=374.00, P=0.046]. Conclusions:The features of oral microbiota vary in women during the preconception period and the third trimester. There is a significant increase in the abundance of oral pathogenic and opportunistic bacteria in the third trimester.